Search Our Scientific Publications & Authors

Oncotarget 2018 Dec 28;9(102):37798-37806. Epub 2018 Dec 28.

H. Lee Moffitt Cancer Center & Research Institute, GU Oncology MMG, Tampa, FL 33612-9497, USA.

Background: Active surveillance (AS) has evolved as a management strategy for men with low grade prostate cancer (PCa). However, these patients report anxiety, doubts about the possible progression of the disease as well as higher decisional conflict regarding selection of active surveillance, and have been reported to ultimately opt for treatment without any major change in tumor characteristics. Currently, there is a paucity of research that systematically examines alternate strategies for this target population. Read More

Minerva Urol Nefrol 2018 Nov 7. Epub 2018 Nov 7.

Sezione di Scienze Radiologiche, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli Studi di Palermo, Palermo, Italy.

Background: To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values.

Methods: Our population consisted in 81 patients (mean age 65.4) in which 84 suspicious areas were identified. Read More

Prostate 2019 Feb 7;79(2):195-205. Epub 2018 Oct 7.

Medical Faculty, Medical Biology Department, Uludag University, Gorukle, Bursa, Turkey.

Background: Atypical small acinar proliferation (ASAP) is a precursor lesion of prostate cancer (PC), and PC develops from this suspicious focus or an unsampled malignant gland nearby. However, PC-related molecular alterations that could guide the timing of repeat biopsies and help monitor PC risk in ASAP-diagnosed patients have not been investigated. The purpose of this study was to first investigate the expression of seven different PC-related RNAs that included serine 2 (TMPRSS2): erythroblastosis virus E26 oncogene homolog (ERG) gene (TMPRSS2-ERG, T2E) fusion, alpha-methylacyl-CoA racemase (AMACR), kallikrein related peptidase 3 (KLK3), androgen receptor (AR), prostate cancer specific antigen 3 (PCA3), and matrix metalloproteinases (MMP)-2 and 9. Read More

Arch Pathol Lab Med 2018 Aug;142(8):938-946

From the Department of Pathology and Urology, University of California Irvine, Orange (Dr Lee); and the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weil Cornell Medical College, Houston, Texas (Dr Ro).

Context: - The presence of cribriform glands/ducts in the prostate can pose a diagnostic challenge. Cribriform glands/ducts include a spectrum of lesions, from benign to malignant, with vastly different clinical, prognostic, and treatment implications.

Objective: - To highlight the diagnostic features of several entities with a common theme of cribriform architecture. Read More

Hum Pathol 2018 Sep 24;79:116-121. Epub 2018 May 24.

Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210, USA. Electronic address:

Extended prostate needle core biopsies are standard of care for the diagnosis of prostatic carcinoma. Subsequent biopsies may be performed for a variety of indications. Knowledge of biopsy characteristics indicating risk for progression may have utility to guide therapeutic management. Read More

Urol Ann 2018 Jan-Mar;10(1):15-19

Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey.

Background: We investigated the correlation between the sampled number of cores in rebiopsy and the cancer detection rate (CDR).

Materials And Methods: Two hundred and twelve patients with normal rectal examination who had undergone rebiopsy in the past 5 years were examined retrospectively. Moreover, 68% of them had undergone 12 cores (Group 1) while 32% had undergone 20 cores (Group 2). Read More

Gene 2018 Mar 22;645:69-75. Epub 2017 Dec 22.

Uludag University, Faculty of Medicine, Medical Biology Department, Gorukle, Bursa, Turkey. Electronic address:

Genetic rearrangements involving androgen-regulated transmembrane protease serine 2 (TMPRSS2) and genes from the ETS transcription factor family, most commonly ERG and ETV1, result in alteration that responsible for oncogenic activity in prostate cancer (PC). The aims of the present study were to: 1) investigate the frequency of these fusion transcripts in prostate tissue samples obtained from patients diagnosed with atypical small acinar proliferation (ASAP), 2) determine any clinical significance of T2E expression at the RNA level in predicting PC detection in subsequent biopsies, and 3) evaluate expression of the PC marker, alpha-methylacyl-CoA racemase (AMACR), according to T2E status by real-time quantitative reverse transcription PCR (RT-qPCR). T2E transcripts were detected in 31. Read More

Curr Urol 2017 Nov 22;10(4):199-205. Epub 2017 Oct 22.

Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK.

Introduction: Atypical small acinar proliferation (ASAP) and high grade prostatic intraepithelial neoplasia (HGPIN) are considered precancerous. We aimed to measure the rate of repeat biopsy and adenocarcinoma in patients with ASAP and HGPIN and identify any clinico-pathologic parameters at diagnosis of ASAP/HGPIN that are predictive of adenocarcinoma.

Materials And Methods: Patients with a diagnosis of ASAP/HGPIN with no previous or concomitant cancer were identified. Read More

Am J Clin Pathol 2017 Nov;148(6):494-501

Department of Pathology, The Ohio State University Medical Center, Columbus.

Objectives: To determine whether pathologists in a tertiary care institution vary in diagnosis and immunohistochemical stain usage in prostate biopsy specimens.

Methods: Men who underwent prostate needle biopsies between 2008 and 2013 were included.

Results: In total, 1,777 prostate biopsy specimens diagnosed by nine pathologists showed variation in diagnostic reporting (atypical small acinar proliferation, 2. Read More

Int J Mol Sci 2017 Nov 20;18(11). Epub 2017 Nov 20.

Institute of Life Sciences, "Vasile Goldis" Western University of Arad, Str. Liviu Rebreanu 86, 310045 Arad, Romania.

This is the first study investigating the clinical relevance of 5-hydroxymethylcytosine (5hmC) in genomic DNA from white blood cells (WBC) in the context of prostate cancer (PCa) and other prostate pathologies. Using an enzyme-linked immunosorbent assay, we identified significantly different distributions of patients with low and elevated 5hmC content in WBC DNA across controls and patients with prostate cancer (PCa), atypical small acinar proliferation (ASAP), and benign prostatic hyperplasia (BPH). The measured values were within the normal range for most PCa patients, while the latter category was predominant for ASAP. Read More

Int Urol Nephrol 2018 Jan 24;50(1):1-6. Epub 2017 Oct 24.

Division of Urology, Department of Surgery, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX, 77555, USA.

Purpose: Guidelines for atypical small acinar proliferation (ASAP) diagnosed on prostate biopsy recommend repeat biopsy within 3-6 months after diagnosis. We sought to discern the rate of detecting clinically significant prostate cancer on repeat biopsy and predictors associated with progression.

Materials And Methods: We performed a retrospective chart review of patients who underwent prostate biopsy at our institution from January 1, 2008, to December 31, 2015. Read More

Res Rep Urol 2017 21;9:187-193. Epub 2017 Sep 21.

Department of Urology, Nara Medical University.

Objective: The objective of this study was to evaluate whether high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP) predict prostate cancer (PCa) during repeat transperineal template saturation biopsy with a high number of cores per prostate volume in patients with persistent clinical suspicion of PCa who underwent at least one previous negative transrectal ultrasound (TRUS)-guided biopsy.

Methods: We retrospectively evaluated 135 consecutive patients with persistent clinical suspicion of PCa, despite a set of negative TRUS-guided biopsies and increasing prostate-specific antigen levels; abnormal findings on digital rectal examination, TRUS, or magnetic resonance imaging; previous biopsy showing HGPIN; and previous biopsy showing atypical glands. Transperineal template saturation biopsy (TTSB) was performed at 5mm intervals to sample one core for each 1 mL of prostate volume. Read More

Urology 2017 Dec 6;110:161-165. Epub 2017 Sep 6.

Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT.

Objective: To assess the incidence of clinically significant and insignificant prostate cancer after an initial biopsy that revealed either atypical small acinar proliferation (ASAP), high-grade prostatic intraepithelial neoplasia (HGPIN), or benign tissue.

Materials And Methods: We retrospectively identified patients diagnosed with ASAP, HGPIN, or benign tissue who had a repeat prostate biopsy within 1 year of diagnosis during 1987-2015. We compared the incidence of any prostate cancer and clinically significant prostate cancer (based on Gleason score, prostate-specific antigen (PSA), number of positive cores, and core volume) for each diagnostic group. Read More

Crit Rev Clin Lab Sci 2017 08 22;54(5):309-325. Epub 2017 Aug 22.

c Department of Urology and Renal Transplantation , University of Foggia , Foggia , Italy.

As much as 5% of prostate biopsies yield findings equivocal for malignancy even for skilled uropathologist; such "grey zone" lesions have been addressed in many ways, although the acronym ASAP (atypical small acinar proliferation) is the most widely used when referring to an atypical focus suspicious, but not diagnostic, for malignancy. Since the introduction of this diagnostic category more than 20 years ago, debate has ensued over its histological characterization and clinical significance. Pathology reporting of ASAP, commonly based on strict morphological criteria and traditional immunohistochemical markers such as basal cell antibodies, has been improved by recent availability of novel immunohistochemical markers such as AMACR and ERG. Read More

Urol Oncol 2017 10 7;35(10):604.e17-604.e24. Epub 2017 Aug 7.

Department of Surgery, University Health Network, University of Toronto, Toronto, Canada; Department of Pathology, University Health Network, University of Toronto, Toronto, Canada.

Introduction: To reduce unnecessary prostate biopsies while using novel tests judiciously, we created a tool to predict the probability of clinically significant prostate cancer (CSPC) vs. low-risk prostate cancer or negative biopsy (i.e. Read More

Asian J Androl 2018 Jan-Feb;20(1):15-18

Department of Urology, Polytechnic University of Marche, Ancona 60126, Italy.

The current literature does not support the usefulness of clinical markers on predicting which patients with atypical small acinar proliferation (ASAP) are more likely to progress to prostate cancer (PCa). Androgens have long been considered to be the potential risk factors for PCa. However, the role of testosterone is controversial. Read More

Clin Genitourin Cancer 2017 12 26;15(6):e995-e999. Epub 2017 Apr 26.

Department of Urology, Tulane University School of Medicine, New Orleans, LA; Southeast Louisiana Veterans Health Care Services, New Orleans, LA. Electronic address:

Background: African American (AA) men are known to have more aggressive prostate cancer (PCa) compared with Caucasian American men. We sought to determine predictors of subsequent detection and risk stratification of PCa in a racially diverse group of men with atypical small acinar proliferation (ASAP) on initial prostate biopsy.

Materials And Methods: A retrospective analysis was conducted on data from men with ASAP on initial prostate biopsy who subsequently received confirmatory biopsies between September 2000 and July 2015. Read More

Urologia 2017 May 16. Epub 2017 May 16.

Urology Department, Faculty of Medicine, Necmettin Erbakan University, Konya - Turkey.

Aim: We aimed to compare the 18 and 16-Gauge (G) needles used in transrectal ultrasonography (TRUS)-guided needle biopsy for cancer detection rates and complications using the Clavien Scoring System.

Materials And Methods: The 80 patients who were included in the study were randomized and divided into two groups. Group 1 (n = 36) had a TRUS-guided prostate biopsy with an 18G needle and Group 2 had a 16G needle (n = 44). Read More

Am Health Drug Benefits 2016 Dec;9(9):497-502

President and Medical Director, QDx Pathology Services, Cranford, NJ.

Background: Prostate cancer is the most common cancer diagnosed in men in developed countries. Using molecular testing may help to improve outcomes in this clinically challenging group. Since 2011, the Prostate Core Mitomic Test (PCMT), which quantifies a 3. Read More

Urology 2017 Sep 21;107:5-10. Epub 2017 Apr 21.

University of Melbourne, Department of Surgery, Austin Health, Melbourne, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Australia.

Multiparametric magnetic resonance imaging (mpMRI) has added to the armamentarium for the diagnosis and surveillance for organ-confined prostate cancer. Atypical small acinar proliferation and high-grade prostatic intraepithelial neoplasia (HGPIN) are premalignant prostatic lesions. The management of such lesions remains contentious, and the addition of mpMRI introduces further uncertainty, given its ability to pick up indolent lesions and its use in targeted biopsy. Read More

Can J Urol 2017 Apr;24(2):8714-8720

Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Introduction: To report the incidence and characteristics of cancer following a diagnosis of atypical small acinar proliferation (ASAP) and comment on current clinical practice recommendations.

Materials And Methods: We reviewed patients that underwent prostate biopsy between 2008 and 2013 at a single institution. Men with ASAP without previous cancer were included. Read More

Ann Diagn Pathol 2017 Apr 7;27:34-42. Epub 2017 Jan 7.

Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, United States. Electronic address:

Objectives: We studied the frequency, inter-pathologist variation, appropriateness and utility of immunohistochemistry (IHC) performed on prostate biopsies (PB) to determine the significance of foci of suspicious glands/atypical small acinar proliferations (ASAP).

Methods: We calculated the rate of IHC use and diagnostic rate of ASAP and adenocarcinoma in PB from 01/01/2008 to 06/30/2015 for individual pathologists working in a tertiary academic institution, and correlated them with the pathologists' experience, subspecialization and PB volume with the aim of determining the interpathologist variation and appropriateness of use of IHC according to recently published recommendations, and the usefulness of IHC to resolve foci of ASAP as either benign or adenocarcinoma.

Results: IHC was used in 966/2652 (36. Read More

J Urol 2017 Aug 28;198(2):322-328. Epub 2017 Feb 28.

Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Department of Urology, University of Michigan (AL, SH, ZM, SL, JEM, DCM, KRG), Ann Arbor, Michigan.

Purpose: We examined rebiopsies in MUSIC (Michigan Urological Surgery Improvement Collaborative) to understand adherence to guidelines recommending repeat prostate biopsy in patients with multifocal high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation.

Materials And Methods: We analyzed data on men undergoing repeat biopsy, practice patterns and cancer detection rates. Multivariate regression modeling was used to calculate the proportion of patients undergoing rebiopsy. Read More

Oncotarget 2016 10;7(43):70794-70802

Moffitt Cancer Center & Research Institute, Inc., Biostatistics and Bioinformatics, Tampa, FL 33612-9497, USA.

Purpose: Although preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk, several preclinical studies and case reports have reported liver toxicities and acute gastrointestinal bleeding. Based on these observations, regulatory bodies have required stringent inclusion criteria with frequent, excessive toxicity monitoring and early stopping rules in clinical trials. These requirements have impeded recruitment and retention of subjects in chemoprevention trials and subsequent progress in agent development efforts. Read More

World J Urol 2017 Jul 29;35(7):1009-1013. Epub 2016 Nov 29.

Department of Pathology, Wheeling Hospital, Wheeling, WV, USA.

Purpose: To evaluate the role of transperineal template-guided mapping biopsy (TTMB) in patients with atypical small acinar proliferation (ASAP) diagnosed via transrectal ultrasound-guided needle biopsy (TRUS).

Methods: In total, 132 consecutive patients with TRUS-diagnosed ASAP underwent TTMB by means of an anatomic-based technique with sampling of 24 biopsy regions. For each of the 24 regions, 1-3 biopsy cores were obtained (depending on prostate size). Read More

Can Urol Assoc J 2016 Sep-Oct;10(9-10):342-348

Robarts Research Institute.

Introduction: This study evaluates the clinical benefit of magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy over systematic biopsy between first-time and repeat prostate biopsy patients with prior atypical small acinar proliferation (ASAP).

Materials: 100 patients were enrolled in a single-centre prospective cohort study: 50 for first biopsy, 50 for repeat biopsy with prior ASAP. Multiparameteric magnetic resonance imaging (MP-MRI) and standard 12-core ultrasound biopsy (Std-Bx) were performed on all patients. Read More

Anticancer Res 2016 09;36(9):4895-901

Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C.

Background/aim: Expanded indications are not yet reported for robotic-assisted laparoscopic radical prostatectomy (RARP) performed by experienced surgeons for patients with preoperative suspicion of prostate cancer. We report our experience with 55 cases of prophylactic RARP for preoperative suspicion of prostate cancer, including postoperative pathological characteristics and outcomes.

Patients And Methods: This retrospective study reviewed data of a subset of 55 consecutive patients among 1,060 patients who underwent RARP for preoperative suspicion of prostate cancer. Read More

Int Urol Nephrol 2016 Dec 31;48(12):2015-2021. Epub 2016 Aug 31.

Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, 11203, USA.

Purpose: Racial differences in the incidence of prostate cancer on initial biopsy are well established, but the predictive value of African American race on the probability of prostate cancer detection on repeat biopsy is unknown.

Materials And Methods: At a single institution between January 2007 and June 2014, we reviewed 277 men who first underwent a negative transrectal ultrasound guided needle biopsy of the prostate, and who then subsequently underwent a second biopsy. Detection rates were compared via Chi-square analysis. Read More

Clin Genitourin Cancer 2016 10 23;14(5):361-365. Epub 2016 Feb 23.

Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland; Department of Oncologic Pathology and Prophylactics, Poznan University of Medical Sciences and Department of Oncologic Pathology, Greater Poland Cancer Center, Poznan, Poland.

Prostate cancer is the second leading cause of cancer death in men, behind only lung cancer. In some cases, the proper diagnosis of prostatic neoplasia can be challenging, and the differential diagnosis includes atypical nonmalignant lesions such as atrophy, atypical adenomatous hyperplasia (AAH), and atypical small acinar proliferation (ASAP). Atrophy and AAH have a benign clinical outcome, and if detected on needle biopsy or transurethral resection of the prostate, clinical follow-up seems appropriate. Read More

Curr Urol 2015 Jul 10;8(2):96-100. Epub 2015 Jul 10.

Department of Urology, The Canberra Hospital, Garran, Australia; The Australian National University, Garran, Australia.

Objective: To determine whether prostate image reporting and data system (PIRADS) 3 lesions as assessed by a 3T multiparametric magnetic resonance imaging (MRI) represent clinically significant prostate cancer.

Method: A retrospective review was performed on a series of consecutive patients who underwent MRI guided biopsy of the prostate for clinical suspicion of prostate cancer between January 2013 and March 2014. Demographic, clinical, MRI and biopsy data were reviewed and compared. Read More

Prostate Cancer Prostatic Dis 2016 Mar 17;19(1):68-71. Epub 2015 Nov 17.

Division of Urology, Rhode Island Hospital, Providence, RI, USA.

Background: Atypical small acinar proliferation (ASAP) occurs in approximately 5% of prostate biopsies. Approximately 30-40% of patients with ASAP may develop prostate cancer (PCa) within a 5-year period. Current guidelines recommend a repeat biopsy within 3-6 months after the initial diagnosis. Read More

Prostate Int 2015 Dec 23;3(4):115-7. Epub 2015 Oct 23.

Institute of Pathology, St. Luke Medical Center-Quezon City, Quezon City, Philippines; Institute of Pathology, St. Luke's Medical Center-Global City, Taguig City, Philippines.

Purpose: Borderline prostatic lesions, with insufficient histomorphologic features, to be definitely diagnosed as prostatic adenocarcinoma (PCa) are often signed out as "atypical glands suspicious for carcinoma" or atypical small acinar proliferation (ASAP). These findings that eventually warrant either immunohistochemical (IHC) studies or a repeat biopsy, prove to be more burdensome to patients in developing countries (such as the Philippines), where health care is not as progressive nor is it an utmost priority. At the same time, in countries like the Philippines, there is a shortage of urological pathologists. Read More

Urologia 2016 May 30;83(2):71-6. Epub 2015 Dec 30.

Department of Urology, Hacettepe University School of Medicine, Ankara - Turkey.

Background: Transperineal prostate biopsy (STPB) is associated with an improved cancer detection rate and an increase in anterior and apical prostate cancers compared to standard transrectal biopsy.

Patients And Methods: A total of 48 men with at least two sets of prior prostate biopsies underwent transrectal ultrasound-guided STPB. Prostate rebiopsy indications were serum prostate-specific antigen (PSA) levels greater than 2. Read More

Korean J Urol 2015 Dec 26;56(12):796-802. Epub 2015 Nov 26.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy.

Materials And Methods: We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). Read More

Urologiia 2015 Dec(6):58-67

Clinic of Urology, Sechenov First Moscow State Medical University Research Institute of Uronephrology and Human Reproductive Health.

Prevention of prostate cancer (PCa) is a vital problem dictated by the obvious benefit of prevention compared to the complexity of treatment. To date, a tremendous amount of research both in vitro, and in vivo assessment of different prophylactic measures has been published. They included consumption of protein, carbohydrate, fat, fiber, vegetable extracts and other solid products, and combinations thereof in the diet, vitamins, minerals, and biologically active substances, medicaments. Read More

Actas Urol Esp 2016 Jan-Feb;40(1):17-22. Epub 2015 Oct 26.

Departamento de Patología, Instituto Nacional de Nutrición, Salvador Zubirán Vasco de Quiroga, México D.F., México. Electronic address:

Objectives: In most prostate biopsies, the seminal epithelium is easily recognised because it meets characteristic histological criteria. However, some biopsies can mimic malignant or premalignant prostatic lesions. The aims of this study were to analyse the histological appearance of the biopsies that mimic adenocarcinomas or preneoplastic prostatic lesions, discuss the differential diagnosis and determine the frequency of seminal epithelia in prostate biopsies. Read More

Prostate Cancer 2015 14;2015:810159. Epub 2015 Sep 14.

Section of Minimally Invasive Urology, The Warren Alpert Medical School of Brown University, Providence, RI 02905, USA.

Purpose. Atypical small acinar proliferation (ASAP) is diagnosed in 1-2% of prostate biopsies. 30-40% of patients with ASAP may be diagnosed with prostate cancer (PCa) on repeat biopsy. Read More

BMC Urol 2015 Jul 23;15:70. Epub 2015 Jul 23.

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Backgrounds: Urologists use biopsy Gleason scores for patient counseling, prognosis prediction, and decision making. The accuracy of Gleason grading is very important. However, the variability of Gleason grading between general pathologists cannot be overlooked. Read More

Prostate Cancer Prostatic Dis 2015 Sep 9;18(3):270-5. Epub 2015 Jun 9.

1] Department of Urology, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy [2] Postgraduate Speciality School of Specialization in Urology, University of Bologna, Bologna, Italy [3] Department of Specialistic, Diagnostic and Experimental Medicine, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Background: To assess whether the addition of clinical Gleason score (Gs) 3+4 to the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria affects pathologic results in patients who are potentially suitable for active surveillance (AS) and to identify possible clinical predictors of unfavourable outcome.

Methods: Three hundred and twenty-nine men who underwent radical prostatectomy with complete clinical and follow-up data and who would have fulfilled the inclusion criteria of the PRIAS protocol at the time of biopsy except for the addition of biopsy Gs=3+4 and with at least 10 cores taken have been evaluated. One experienced genitourinary pathologist selected those with real Gs=3+3 and 3+4 in only one core according to the 2005 International Society of Urological Pathology criteria. Read More

Prostate Cancer Prostatic Dis 2015 Sep 21;18(3):255-9. Epub 2015 Apr 21.

1] Department of Urology, University of Minnesota, Minneapolis, MN, USA [2] Department of Pathology, Department of Veterans Affairs Hospital, Minneapolis, MN, USA.

Background: Limited information is known about the clinical significance of cancers diagnosed upon repeat biopsy for the indication of atypical small acinar proliferation (ASAP). With increasing concern regarding overdiagnosis and overtreatment of prostate cancer, and the reported rise in infectious complications related to prostate biopsy, we examined the outcomes of patients rebiopsied for a diagnosis of ASAP.

Methods: Clinical, pathologic and outcomes data of patients diagnosed with ASAP on prostate biopsy at our institutions between 2000 and 2010 were abstracted through chart review. Read More

Prostate 2015 Aug 20;75(11):1177-86. Epub 2015 Apr 20.

Department of Scienza e Tecnologia del Farmaco, University of Turin, Turin, Italy.

Background: Antioxidants effectiveness in prostate cancer (PCa) chemoprevention has been severely questioned, especially after the recent results of the Selenium and Vitamin E Cancer Prevention Trial. We present the results of a double-blind randomized controlled trial (dbRCT) on the pharmacokinetic, clinical, and molecular activity of dietary supplements containing lycopene, selenium, and green tea catechins (GTCs) in men with multifocal high grade prostatic intraepithelial neoplasia (mHGPIN) and/or atypical small acinar proliferation (ASAP).

Methods: From 2009 to 2014, we conducted a dbRCT including 60 patients with primary mHGPIN and/or ASAP receiving daily lycopene 35 mg, selenium 55 µg, and GTCs 600 mg, or placebo for 6 months. Read More

Cancer Prev Res (Phila) 2015 Oct 14;8(10):879-87. Epub 2015 Apr 14.

Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida.

Preclinical, epidemiologic, and prior clinical trial data suggest that green tea catechins (GTC) may reduce prostate cancer risk. We conducted a placebo-controlled, randomized clinical trial of Polyphenon E (PolyE), a proprietary mixture of GTCs, containing 400 mg (-)-epigallocatechin-3-gallate (EGCG) per day, in 97 men with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP). The primary study endpoint was a comparison of the cumulative one-year prostate cancer rates on the two study arms. Read More

Int Urol Nephrol 2015 May 8;47(5):735-41. Epub 2015 Apr 8.

Policlinico di Modena, Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy,

Purpose: Stereotactic biopsy has improved prostate cancer detection. Although the new approach is superior, standard procedure is still useful in a cohort of patients in whom MRI is not available. The standard saturation biopsy technique is still debatable. Read More

Urologe A 2015 Nov;54(11):1596, 1598-601

Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.

Background: Modern imaging modalities improve prostate diagnostics.

Objectives: This study was performed to determine the outcome characteristics of biopsy procedures using the results of HistoScanning(TM) analysis (HS) for identifying prostate cancer (PCa) in patients with perineal template-guided prostate biopsy.

Patients And Methods: A total of 104 consecutive men (mean age 69 years, mean PSA 9. Read More

Arch Ital Urol Androl 2014 Dec 30;86(4):356-8. Epub 2014 Dec 30.

Institute of Urology, AOU United Hospitals, Polytecnic University of Marche Region, Ancona.

Objectives: To establish whether repeated trans-rectal ultrasound-guided Prostate Needle Biopsies (PNBx) performed in men with diagnosis of Small Acinar Atypical Proliferation (ASAP) predispose these subjects to Erectile Dysfunction (ED) and to evaluate if EcoColorDoppler (ECD) can help to reduce this side effect.

Materials And Methods: We performed a retrospective study regarding 190 men with diagnosis of ASAP detected between January 2001 and December 2011, who underwent to repeated prostate needle biopsies (PNBx). These patients were investigated about Erectile Function (EF) and Lower Urinary tract Symptoms (LUTS) using International Index of Erectile Function (IIEF-5) and International Prostate Symptom Score (IPSS) questionnaires before the first PNBx and 3 months after each other one. Read More

Arch Ital Urol Androl 2014 Dec 30;86(4):332-5. Epub 2014 Dec 30.

Institute of Urology, Azienda Ospedaliera-Universitaria, Polytechnic University of Marche Region, Ospedali Riuniti Ancona.

The incidence of prostate cancer (PCA) was evaluated in 155 patients with isolated Atypical Small Acinar Proliferation (ASAP) found on initial prostate biopsy, after a medium-term follow-up (40 months) with at least one re-biopsy. Clinical and histological data were analysed. Cancer was detected in 81 of 155 (52. Read More

Arch Ital Urol Androl 2014 Dec 30;86(4):288-90. Epub 2014 Dec 30.

Keçioren Training and Research Hospital, Departmant of Urology, Ankara.

Objective: To evaluate the pathologic and clinic results of our large series of transrectal prostate biopsies in relation to Gleason score, age and PSA level.

Materials And Methods: We reviewed the pathologic results of transrectal prostate biopsies performed because of high PSA levels and abnormal digital rectal examination findings between January 2008 and February 2012.

Results: The pathologic result of 835 prostate biopsies was benign in 82. Read More

World J Gastroenterol 2015 Jan;21(4):1349-56

Sohsuke Yamada, Atsunori Nabeshima, Hirotsugu Noguchi, Aya Nawata, Xin Guo, Ke-Yong Wang, Toshiyuki Nakayama, Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.

A 4-mo history of both epigastralgia and back pain was presented in a 39-year-old male. Computed tomography showed right lung nodule and abdominal mass attached to the gastric wall, measuring approximately 30 mm and 70 mm in diameter. Since biopsy samples from the lung and abdomen revealed poorly differentiated adenocarcinoma and malignant tumor, clinicians first interpreted the abdominal mass as metastatic carcinoma, and a right lower lobectomy with following resection of the mass was performed. Read More

Rom J Morphol Embryol 2014 ;55(3 Suppl):1161-6

Department of Urology, "Grigore T. Popa" University of Medicine and Pharmacy, Iassy, Romania;

Aim: To highlight the role of prostate rebiopsy in the diagnosis of prostate cancer (PCa) in cases with an atypical small acinar proliferation (ASAP) diagnosis on the initial biopsy.

Materials And Methods: A retrospective study on 1525 patients who underwent prostate needle biopsy (PB) over a period of four years (2009-2012) was performed. For each patient the following were analyzed: age, prostate volume, digital rectal examination (DRE), serum total prostate specific antigen (tPSA), number of the cores taken. Read More

Prostate 2015 May 16;75(7):673-8. Epub 2015 Jan 16.

Urology Division, Hartford Hospital, Hartford, Connecticut, USA.

Background: While the treatment pathway in response to benign or malignant prostate biopsies is well established, there is uncertainty regarding the risk of subsequently diagnosing prostate cancer when an initial diagnosis of prostate atypia is made. As such, we investigated the likelihood of a repeat biopsy diagnosing prostate cancer (PCa) in patients in which an initial biopsy diagnosed prostate atypia.

Methods: We reviewed our prospectively maintained prostate biopsy database to identify patients who underwent a repeat prostate biopsy within one year of atypia (atypical small acinar proliferation; ASAP) diagnosis between November 1987 and March 2011. Read More